Stark, Shana S

Stark, Shana S is an individual health care provider with primary practice located at 500 5Th St , Brookings OR 97415-9702. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Stark, Shana S can be contacted via phone (541) 412-2000.

Contact Information

Primary practice address
500 5Th St Brookings OR 97415-9702
Phone: (541) 412-2000
Fax: (541) 412-2081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201501818NP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 111628 Nebraska

Profile Details

NPI number 1124443676
LBN Legal business name Stark, Shana S
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2014
Last updated Sep 16th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124443676 NPPES
Oregon MEDICAID 500684342
Oregon Other 1487696985
Oregon Other 930937095

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